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Organization
KELLIE J JENSEN
Active
Organization
KELLIE J JENSEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE J JENSEN LCSW (LICENSED CLINICAL SOCIAL WORKER)
(307) 217-1311
Entity
Organization
Contact information
Practice address
729 FORT ST, BUFFALO, WY 82834-2316
(307) 217-1311
(307) 684-2182
Mailing address
729 FORT ST, BUFFALO, WY 82834-2316
(307) 217-1311
(307) 684-2182
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
661
WY
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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